Basal and stimulated hypothalamic-pituitary-adrenal axis activity in patients with functional gastrointestinal disorders and healthy controls
Basal and stimulated hypothalamic-pituitary-adrenal axis activity in patients with functional gastrointestinal disorders and healthy controls
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DOI：
10.1097/01.psy.0000157064.72831.ba
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发表时间：
2005-03-01
影响因子：
3.3
通讯作者：
Ehlert, U
中科院分区：
文献类型：
--
作者：
Böhmelt, AH;Nater, UM;Ehlert, U
目的：探讨功能性胃肠道疾病患者在刺激和非刺激条件下垂体-肾上腺功能的变化。方法：30名符合罗马肠易激综合征或非溃疡性消化不良诊断标准的受试者和24名健康对照参加研究。所有受试者都获得了早晨唾液中的游离皮质醇和白天的皮质醇图谱。第二天，进行小剂量地塞米松抑制试验。此外，对所有受试者进行促肾上腺皮质激素释放激素(CRH)激发试验。结果：结果显示，与对照组相比，患者的非刺激性皮质醇水平降低。CRH刺激后，肾上腺皮质激素和皮质醇反应减弱。这些发现提示功能性胃肠道疾病患者的脑下垂体和肾上腺皮质活动降低。结论：在这些患者中观察到的垂体-肾上腺反应性可能是肾上腺皮质活动降低的结果，可能导致脑内CRH的去抑制。
Objective: The aim of this study was to investigate alterations of pituitary-adrenal activity under both stimulated and unstimulated conditions in patients with functional gastrointestinal disorders. Methods: Thirty subjects who fulfilled the Rome Diagnostic Criteria for either irritable bowel syndrome or nonulcer dyspepsia and 24 healthy controls took part in the study. Free salivary morning cortisol and diurnal cortisol profiles were obtained for all subjects. On a second day, a low-dose dexamethasone suppression test was applied. Additionally, in all subjects a corticotropin-re leasing hormone (CRH) challenge test was performed. Results: The results show attenuated unstimulated cortisol levels in patients compared with controls. After CRH challenge, blunted adrenocorticotropic hormone and cortisol responses were observed. These findings suggest lower pituitary and adrenocortical activity in patients with functional gastrointestinal disorders. Conclusion: The observed pituitary-adrenal reactivity in these patients is discussed as a possible consequence of lower adrenocortical activity, possibly resulting in a disinhibition of CRH in the brain.